130 CMR 503.007 - Potential Sources of Health Care
The MassHealth agency is the payer of last resort and pays for health care and related services only when no other source of payment is available, except as otherwise required by federal law.
(A)
Health
Insurance. Every applicant and member must obtain and maintain
available health insurance in accordance with
130 CMR 505.000:
Health Care Reform: MassHealth: Coverage Types. Failure to do
so may result in loss or denial of eligibility unless the applicant or member
is
(1) receiving MassHealth Standard or
MassHealth CommonHealth; and
(2)
younger than 21 years old or pregnant.
(B)
Use of Benefits.
The MassHealth agency does not pay for any health care and related services
that are available
(1) through the member's
health-insurance, if any; or
(2) at
no cost to the member including, but not limited to, any such services that are
available through any agency of the local, state, or federal government, or any
entity legally obligated to provide those services.
(C)
Employer-sponsored Health
Insurance. The MassHealth agency may enroll MassHealth members in
available employer-sponsored health insurance if that insurance meets the
criteria for payment of premium assistance under
130 CMR
506.012(B):
Criteria.
Notes
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No prior version found.